Audio Qbank – HY USMLE Q #587 – Biochemistry (hard)

A 48-year-old man comes to the physician for a routine health maintenance examination. He is currently taking Tuberculosis prophylaxis following a positive PPD test 4 months ago. He mentions occasional paresthesias of his left hand. Physical examination shows no abnormalities. Impairment of which of the following is most likely to be seen in this patient?

Acetyl-CoA synthesis
Carboxylation of propionyl-CoA
Fumarate synthesis
Hepatic transamination
Tetrahydrofolate synthesis